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Reproducibility of mean transit time for maximal myocardial flow assessment by videodensitometry

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Abstract

In the assessment of myocardial perfusion by ECG-triggered digital radiography, time parameters are calculated from the time density curve (TDC) and related to blood flow.

Recently we developed a method which uses mean transit time (T mn ) as time parameter, and which is in accordance with the original principles of indicator dilution theory. In this approach, variability in vascular volume is excluded and T mn −1, determined at maximal hyperemia, showed an excellent correlation with maximal flow in animal validation studies. For calculation of T mn , however, a large part of the descending limb of the TDC has to be known for reliable extrapolation, and especially this part of the curve is subject to variability in image quality in man. Therefore we tested reproducibility of T mn in 30 arteries in 20 patients. T mn was derived from the TDCs, obtained from paired studies under identical circumstances with an interval of 10 minutes. Satisfactory images could be obtained in all but one patient. Image processing was performed in an identical way in the paired studies. Reproducibility proved to be excellent for all three coronary arteries. The absolute value of the relative differences between the first and second determination was 7±7% for the LAD, 6±3% for LCx and 4±2% for the RCA (mean ± SD). Correlation coefficients between both measurements were 0.97, 0.95 and 0.95 for the respective arteries. Therefore, it is concluded that, using this approach, T mn at maximal hyperemia can be determined reproducibly in man and used for maximal myocardial flow assessment.

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Abbreviations

LAD:

left anterior descending artery

LCA:

left coronary artery

LCx:

left circumflex artery

Pa :

mean arterial pressure

RCA:

right coronary artery

ROI:

region of interest

TDC:

time density curve

T mn :

mean transit time

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Authors and Affiliations

  1. Department of Cardiology, St. Radboud Hospital, University of Nijmegen, Nijmegen, The Netherlands

    Nico H. J. Pijls, Gerard J. H. Uijen, Truus Pijnenburg, Karel van Leeuwen, Wim R. M. Aengevaeren, Jacques D. Barth, Joost den Arend, Albert Hoevelaken & Tjeerd van der Werf

Authors
  1. Nico H. J. Pijls
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  2. Gerard J. H. Uijen
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  3. Truus Pijnenburg
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  4. Karel van Leeuwen
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  5. Wim R. M. Aengevaeren
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  6. Jacques D. Barth
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  7. Joost den Arend
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  8. Albert Hoevelaken
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  9. Tjeerd van der Werf
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Pijls, N.H.J., Uijen, G.J.H., Pijnenburg, T. et al. Reproducibility of mean transit time for maximal myocardial flow assessment by videodensitometry. Int J Cardiac Imag 6, 101–108 (1990). https://doi.org/10.1007/BF02398893

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